| NPI | 1295138998 | 
|---|---|
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX AP126775)  | 
| Additional Taxonomies | 363LP0200X Nurse Practitioner, Pediatrics (Licence: TX 723965)  | 
| Enumeration Date | 2014-10-08 | 
| Last Update Date | 2021-06-03 |